Comparison of Clinical Characteristics and Pregnancy Outcomes in Partial and Complete HELLP Syndrome: An Eight-Year Retrospective Study From a Tertiary Hospital in China

Background: Hemolysis, elevated liver enzymes, and low platelet count syndrome (HELLP syndrome), characterized by hemolysis (H), elevated liver enzymes (EL), and a low platelet count (LP), is a severe obstetric complication. We analyzed the clinical characteristics of complete and partial HELLP syndrome. Methods: We conducted a retrospective study to collect data on 96 pregnant women with preeclampsia accompanied by HELLP syndrome. HELLP syndrome was diagnosed based on the Tennessee Classification System. General characteristics, clinical manifestations, laboratory results, complications, as well as maternal and neonatal outcomes were analyzed to compare complete and partial HELLP syndrome. Results: Among the 96 pregnant women with HELLP syndrome, 76% (73/96) were diagnosed with partial HELLP syndrome, while 24% (23/96) were diagnosed with complete HELLP syndrome. No statistically significant differences were found in maternal and disease characteristics between the partial and complete HELLP groups (all p > 0.05). The main symptoms of HELLP syndrome were headache and epigastric pain. Regarding diagnostic measures, the complete HELLP group had lower platelet counts (PLT) and higher total bilirubin (TBil), lactate dehydrogenase (LDH), alanine transaminase (ALT), and aspartate transaminase (AST) levels compared to the partial HELLP group. For non-diagnostic measures, the complete HELLP group showed higher white blood cell counts and D-dimer levels. No statistically significant differences were observed in the remaining laboratory indexes (all p > 0.05). Similarly, there was no statistically significant differences in the incidence of maternal pregnancy complications and fetal demographic features between the two groups (all p > 0.05). Conclusions: The distinction between partial and complete HELLP syndromes primarily lies in specific laboratory indexes. Both syndromes can lead to severe perinatal complications, including eclampsia, uteroplacental apoplexy, and fetal demise. Clinical diagnosis does not require strict adherence to all three criteria: H, EL, and LP. Special attention should be given to patients with partial HELLP syndrome, who require immediate treatment and intervention.